Circles of Exclusion: The Politics of Health Care in Israel

4 Migrant Workers

4 Migrant Workers “Should we allow a baby with a fever to come to the day care center?” a Colombian woman—one of fourteen immigrants in the room—asked me in Spanish. I wasn’t sure how to answer her. From a purely “medical” perspective , if our goal was to avoid spreading disease and preventing the baby from becoming sicker herself, of course we should insist that the baby stay at home. But I wasn’t asked to speak for the Israeli public. I was asked this question at the end of a meeting organized by Mesila, the city center for support of migrant workers, and I was speaking to migrant women who run day care centers for the children of migrant workers. The meeting was part of a course for community activists and women who run day care centers. Like them, I knew that parents who are migrant workers cannot take adayofftostayhomewiththeirchildren.Eveniftheyareherelegally,they have very limited social rights in Israeli society. In this case, as in so many, most of them were undocumented. Unlike Israeli citizens who have, by law, the right to six days off work to take care of a sick child, migrant workers, whether they arrived in Israel with or without a working visa, Migrant Workers 101 have no right to any time off work. If they don’t go to work, they don’t get paid. Many risk losing their jobs. Dealing with the “technical” arrangements when a child is sick is stressful for all working parents. As a father of four children with our family living in Argentina, I was well aware of that. But either I or my wife could always take the day off and stay at home with our sick child. That was not an option for migrant workers who are parents. Moreover, because most of them left their countries of origins and live here far from friends and families , they have no support networks that they can turn to in an emergency. There are no grandparents, sisters, or brothers they can call to ask to watch a sick baby for the day. Well before I attended this meeting, through my experience as a volunteer at the Physicians for Human Rights’ open clinic for migrant workers, I’d become familiar with the tension between the purely “medical” considerations affecting migrant health and the specific context in which migrant workers live. If I were counseling Israeli parents, I’d tell them to keep their child home from day care or school until the child’s fever was over. If that fever lasted for five days, I’d suggest the parent have a physician do a complete blood count to figure out why the fever persisted. Telling this to a migrant parent seems not only irrelevant but cruel. As I said, before, how can someone living on survival wages afford to take a day off work? To recommend a complete blood count would be to suggest a course of action that few migrant families can afford to undertake. Such a recommendation, I fear, would just make the father or mother feel guilty because they could not do the right thing to care for their child. Which is why individualistic recommendations that assume the affluence necessary to follow them don’t work in this context. Thus, any solutions proposed to individual families or even institutional recommendations like those that have been proposed by groups such as Mesila, have to be complemented with political activism on a broader scale. The plight of migrant workers is yet another aspect of the Israeli health care system that demands understanding and action. The Origins of the Migrant Problem A number of intersecting trends caused significant numbers of migrant workers to arrive in Israel in the early 1990s. The first important trend 102 Circles of Exclusion was the creation of a dual labor market in Israel. This transformation of the Israeli economy began in the 1950s when, for the first time since the Jewish settlement of Israel, the country began to depend on more and more low-wage workers. The economic growth that occurred in Israel in the 1980s and 1990s fueled the need for migrant workers. Israel became even more dependent on migrant workers when it began to restrict Palestinians from the Occupied Territories from working in the country in the 1990s. Finally, the waves of immigration from south to north and...